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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 10/2016

01-10-2016 | Breast Oncology

Fertility in Women of Reproductive Age After Breast Cancer Treatment: Practice Patterns and Outcomes

Authors: Devina K. S. McCray, MD, Ashley B. Simpson, DO, Rebecca Flyckt, MD, Yitian Liu, MD, Colin O’Rourke, MS, Joseph P. Crowe, MD, Stephen R. Grobmyer, MD, Halle C. Moore, MD, Stephanie A. Valente, DO

Published in: Annals of Surgical Oncology | Issue 10/2016

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Abstract

Background

Breast cancer is the most frequently occurring cancer in women of reproductive age, and systemic treatments may adversely affect childbearing plans. Use of assisted reproductive technologies and therapies for ovarian protection improve fertility prospects. We evaluated whether patients had a documented fertility discussion (FD) with their oncology physician prior to therapy, what options were chosen, and if pregnancy was achieved.

Methods

A retrospective chart review from 2006 to 2014 was performed to evaluate women aged 40 years and younger who were diagnosed with breast cancer and treated with chemotherapy and/or antihormonal therapy. Patient demographics, treatment regimens, presence or absence of FD, in vitro fertilization (IVF) consultation, gonadotropin-releasing hormone (GnRH) agonist use, and subsequent successful pregnancy were analyzed.

Results

Among 303 patients meeting the inclusion criteria, 80 (26 %) had an FD with their physician documented; 71 of these 80 women (89 %) sought further fertility consultation and options. Sixteen (20 %) women were prescribed a GnRH agonist only for ovarian protection during chemotherapy, 50 (63 %) underwent IVF consultation only, and 5 (6 %) had both a GnRH agonist prescribed and an IVF consultation. The overall pregnancy rate was 7 % at a mean of 3 years post breast cancer treatment. Pregnancy after treatment was more common among those pursuing IVF consultation or prescribed a GnRH agonist.

Conclusions

In treating young breast cancer patients, it is important to assess fertility desire, discuss treatment risks relating to fertility, and discuss preservation options. Although not every woman in this group desired pregnancy, 71/80 (89 %) women having a documented FD sought further fertility consultation and options.
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Metadata
Title
Fertility in Women of Reproductive Age After Breast Cancer Treatment: Practice Patterns and Outcomes
Authors
Devina K. S. McCray, MD
Ashley B. Simpson, DO
Rebecca Flyckt, MD
Yitian Liu, MD
Colin O’Rourke, MS
Joseph P. Crowe, MD
Stephen R. Grobmyer, MD
Halle C. Moore, MD
Stephanie A. Valente, DO
Publication date
01-10-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 10/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5308-y

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